儿童系膜增生性肾小球肾炎红细胞免疫黏附功能的实验研究  

The experimental study in erythrocyte immuno-adhering function of children patients with mesangioproliferative glomerulonephritis

作　　者：黄韵 戴越刚 王剑 顾岚 

机构地区：[1]上海浦东新区浦南医院检验科,上海200127 [2]上海市儿童医学中心检验科,上海200127 [3]上海市长海医院儿科,上海200433

出　　处：《检验医学》2013年第11期992-994,共3页Laboratory Medicine

摘　　要：目的从红细胞免疫角度探讨儿童系膜增生性肾小球肾炎(MsPGN)的免疫发病机制。方法检测34例MsPGN患儿的红细胞C3b受体花环率(RCR)、肿瘤红细胞花环率(TRR)作为红细胞免疫黏附功能指标;聚合酶链反应(PCR)联合HindⅢ酶切技术测定红细胞第1补体受体(CR1)密度相关基因多态性(HH型、HL型、LL型)。结果 MsPGN患儿的RCR、TRR均低于正常儿童(P<0.01);MsPGN患儿红细胞CR1密度相关基因多态性分布以HH型占大多数,但百分比较对照组明显下降(P<0.05),未检出LL型。在相同基因人群中,MsPGN患儿TRR明显低于对照组(P<0.01);无论是MsPGN组还是对照组,HH型TRR均比HL型高(P<0.01)。结论 MsPGN患儿红细胞膜上CR1活性降低,识别、黏附、清除免疫复合物(IC)的能力下降,循环中的IC在肾小球滤过时沉积于系膜区,引起系膜细胞增生反应,MsPGN患儿红细胞免疫黏附功能显著下降在该病的发病机制中起重要作用。红细胞CR1密度相关基因型别与红细胞免疫黏附功能有关,MsPGN患儿红细胞免疫功能下降可能为继发性下降。Objective To investigate the mechanism of erythrocyte immuno-adhering in the pathogenesis of mesangioproliferative glomerulonephritis （MsPGN）. Methods The erythrocyte immuno-adhering function was measured in 34 children patients with MsPGN. Red blood cell C3b receptor rosette （RCR） and tumor red blood cell rosette （TRR） were determined. The complement receptor type 1 （CR1）density-associated genotypes （HH type, HL type and LL type ） on erythroeyte were determined by polymerase chain reaction （PCR） amplification with Hind Ill restriction enzyme digestion technique. Results RCR and TRR of the children patients with MsPGN were lower than those of healthy children （P 〈 0.01 ）. The most CR1 density-associated genotype on erythrocyte of the children patients with MsPGN was HH type, and HH type percentage of the children patients with MsPGN decreased significantly（ P 〈 0.05 ）. No LL type was determined. TRR of the children patients with MsPGN was lower than that of healthy children with same genotype（ P 〈 0. 01 ）. TRR of HH type was higher than that of HL type （ P 〈 0.01 ）. Conclusions The decreasing activation of erythrocyte CR1 induces low capacities of identifying, adhering, clearing immunocomplex （IC） , which lead to the deposit of glomeruli and the proliferation of mesangial cells. The decrease of erythrocyte immuno- adhering function plays an important role in the pathogencsis of MsPGN. The results of CR1 density-associated genotypes are correlated with the ability of erythrocyte immuno-adhering function. There will be the secondary decrease of erythrocyte immuno-adhering function of MsPGN.

关 键 词：红细胞 免疫功能 第1补体受体 系膜增生性肾小球肾炎 儿童 

分 类 号：R446.11[医药卫生—诊断学]